Cardiovascular stimulants

Question 1

List the cardiovascular stimulants

Answer 1

Epinephrine (E), NE, Ephedrine (F), Phenylephrine, Isoproterenol, Dobutamine (DO), Dopamine (DA).. Go East by NorthEast to Find a Phenylly Isolated DO DAd

Question 2

CV stimulants can be direct acting, indirect acting, or mixed. What does direct acting mean?

Answer 2

Means the drug actually stimulates post-synaptic receptors

Question 3

What does indirect acting mean?

Answer 3

Means the drug increases the availability of E, NE

Question 4

What does mixed acting mean?

Answer 4

Means the drug acts both ways

Question 5

Which type of drug (direct, indirect, or mixed) is affected by Reserpine?

Answer 5

Indirect acting drugs are effected by Reserpine because Reserpine wipes out NE before it gets into its transport vesicle

Question 6

What effects is IV epinephrine going to have?

Answer 6

Increase pulse pressure, increase inotropic and chronotropic effects

Question 7

So, epinephrine increases HR and contractility and decreases TPR thus raising systolic and lowering diastolic. How?

Answer 7

Epi increases systolic pressure by stimulating B1 receptors in the heart. This leads to increased HR/contractility. Epi also stimulates beta 2 receptors in skeletal muscle which vasodilate. This leads to decreased diastolic

Question 8

What would a small dose of Epi do?

Answer 8

decrease BP cuz beta 2 receptors have a higher affinity for epi than do alpha receptors

Question 9

What happens to the relaxation rate of the heart when epi is given?

Answer 9

Relaxation rate increases (lucitropic) so that the heart can pump faster

Question 10

CV concern when giving epi?

Answer 10

PVCs

Question 11

Epinephrine has many effects on vasculature. What vessels does epinephrine work on?

Answer 11

small arterioles and precapillary sphincters

Question 12

what does epi do to cutaneous BF?

Answer 12

decreases

Question 13

what does epi do to skeletal muscle BF?

Answer 13

increases

Question 14

what does epi do to renal BF

Answer 14

decreases because remember there are Beta 1 receptors in the JGA so you get renal vasoconstriction and decreased RBF

Question 15

what does epi do to pulmonary pressures?

Answer 15

increases which can lead to pulmonary edema

Question 16

what does epi do to coronary BF?

Answer 16

increases

Question 17

when you give epi subQ, what is the first thing that happens?

Answer 17

local vasoconstriction

Question 18

Clinical utility of epinepherine?

Answer 18

emergency relief of anaphylaxis, vasoconstrictor with local anesthetics, restores cardiac rhythm in pts with cardiac arrest

Question 19

epi toxicity?

Answer 19

CVA: cerebral hemorrhage, ventricular arrhythmias, angina

Question 20

what does norepinephrine do?

Answer 20

bigtime increase in BP. NE is alpha 1’s thang! it jumps on that alpha 1 and activates the shit out of it giving you profuse vasoconstriction

Question 21

NE is given IV, what should you be concerned about?

Answer 21

Necrosis at injection site

Question 22

Dopamine is a dose dependent drug. What happens if you give a low dose?

Answer 22

D1 receptor predominant, vasodilation; also improves GFR in pts with deminished renal perfusion

Question 23

Dopamine is a dose dependent drug. What happens if you give a moderate dose?

Answer 23

D1 & Beta 1 receptor agonism; increased CO via positive inotropic effect and vasodilation

Question 24

Dopamine is a dose dependent drug. What happens if you give a high dose?

Answer 24

alpha 1 agonism promotes vasoconstriction

Question 25

What does dobutamine do?

Answer 25

increases CO via increasing contractility

Question 26

What is dobutamine's half life?

Answer 26

Bout 2 minutes

Question 27

When is dobutamine used?

Answer 27

For short term treatment of cardiac decompensation (heart surgery, CHF, MI)

Question 28

What does isoproterenol do?

Answer 28

increases HR and contractility and decreases diastolic BP

Question 29

How does isoproterenol do the things it does?

Answer 29

It only activates beta receptors. When it activates beta 1 receptors in the heart, this leads to increased HR and CO. When it activates beta 2 receptors in the skeletal muscle vasculature, it vasodilates

Question 30

What does phenylephrine do?

Answer 30

it is a direct acting alpha 1 agonist that stimulates alpha 1 to increase BP via vasoconstriction

Question 31

What does ephedrine do?

Answer 31

increases TPR, BP, CO, and HR

Question 32

How does ephedrine work?

Answer 32

Mixed acting; it activates alpha 1,2 and beta 1,2 receptors itself but it also stimulates the production of NE

Question 33

Why is ephedrine controlled?

Answer 33

Cuz if you have ephedrine and a trash can, you can make meth

Question 34

Which CV stimulant has positive effects on renal perfusion?

Answer 34

Dopamine

Question 35

Which CV stimulant is a racemic mixture?

Answer 35

Dobutamine

Question 36

Which CV stimulant(s) effects are measured by measuring urine output?

Answer 36

Dopamine and dobutamine